Anaphylactoid and hypersensitivity reactions have been reported for Dexamethasone Sodium Phosphate (see ADVERSE REACTIONS). The more superficial a target structure is, the more drug will be made available for interaction. 1 to 6 mg/kg IV as a single dose or up to 40 mg initially followed by repeat IV doses every 2 to 6 hours while shock persists 181921-23252832 [2] For a patient dealing with burdensome symptoms, that is a long time, and it can lead some to change their treatment plan prematurely. Stack Exchange network consists of 182 Q&A communities including Stack Overflow, the largest, most trusted online community for developers to learn, share their knowledge, and build their careers. Introduction of anti-inflammatory drugs by iontophoresis: double blind study. It is created by eHealthMe based on reports of 105,970 people who have side effects when taking Dexamethasone from the FDA, and is updated regularly. Dexamethasone Sodium Phosphate is a water-soluble inorganic ester of dexamethasone. The electrode is placed 46 inches away when using the electric generator unit type (having leads and electrodes). Can I use expired neomycin and polymyxin b sulfates, dexamethasone ophthalmic? 17 - 27 however, improvement in the patient's condition is not always seen, 28, 29 perhaps due to the variety of iontophoretic conditions used 8 and to the fact that the Why do testosterone / anabolic steroid injection increase the risk of tendon rupture? Are dexamethasone iontophoreses used to treating a tendinopathy known to have any deleterious effect on tendons? Fill Electrode with Medication Fill the opposite electrode with approximately 1 ml of enclosed saline. Fourth day: 0.75 mg orally twice per day Dexamethasone iontophoresis: effect on delayed muscle soreness and muscle function. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Inherent advantages to this method includes the ability to use a wide array of compoundshaving either analgesic or anti-inflammatory actionsapplied directly into the target area. How is lift produced when the aircraft is going down steeply? rev2022.11.9.43021. The penetration is limited, therefore it's less risky than a steroid injection which carries a higher risk of tendon rupture (1). Clinical applications of iontophoretic devices in rehabilitation medicine. Comments: Dosing should be individualized on the basis of disease and patient response From S, et al. Dexamethasone should be started 10 to 20 minutes before or with the first dose of antibiotic; if antibiotics have already been administered, dexamethasone use has not been shown to improve patient outcomes and is not recommended. neurokinin 1 (NK1) antagonists and 5-hydroxytryptamine-3 (5-HT3) antagonists. Iontophoresis has been shown to boost gene or drug transport across the cell membrane by 2.3 and 2.5 times in the cornea and 4.0 and 3.4 times in the conjunctiva, respectively; however, after the current was removed, the transfer recovered to baseline levels in rabbit cornea and conjunctiva . Using the rule of likes repel, the practitioner chooses medications compatible with the active pole being used so that a positively charged drug is loaded into the positive side of the delivery pad or electrode. This drug is not recommended for the treatment of primary adrenal insufficiency because it frequently causes Cushingoid side effects, is difficult to titrate, and has minimal mineralocorticoid activity. Clin Ophthalmol. Therefore, it is recommended that latent or active amebiasis be ruled out before initiating corticosteroid therapy in any patient who has spent time in the tropics or any patient with unexplained diarrhea. There is limited data on use of this drug in the pediatric population; the above dose is from a study in a small number of patients. How does DNS work when it comes to addresses after slash? Available for Android and iOS devices. Received 2008 Feb 5; Accepted 2008 Jul 7. repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle". The highest incidence is in adults aged between 3050 years old. Santi P, Guy RH. Growth and development of infants and children on prolonged corticosteroid therapy should be carefully followed. Making statements based on opinion; back them up with references or personal experience. Mannitol Flux in the Anode-to-Cathode Direction and the Corresponding Solvent Flow for the Experimental Dexamethasone Phosphate (Dex-Phos) Delivery Conditions Tested, Cathodal Dexamethasone Phosphate (Dex-Phos) Flux and Anodal Mannitol Flux and the Deduced Electroosmotic Flow When a Strategy to Reduce the Skin's Negative Charge Was Examined, 100 Transport Numbers of Main Ionic Species During Iontophoretic Delivery of Dexamethasone Phosphate (Dex-Phos) From Different Donor Solutions. Reports of acute toxicity and/or death following overdosage of glucocorticoids are rare. Fluka, Industriestrasse 25, 9471 Buschs, Switzerland. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. This is a public Site and all posts on this Site can be seen by anyone and may be shared freely with others. Cerebral Edema associated with primary or metastatic brain tumor, craniotomy, or head injury. Browse other questions tagged, Start here for a quick overview of the site, Detailed answers to any questions you might have, Discuss the workings and policies of this site, Learn more about Stack Overflow the company, Effect of dexamethasone iontophoreses on tendons, Mobile app infrastructure being decommissioned. This allows for a smaller dose of medication to be used than would be required with other routes of administration. Iontophoresis is a technique using a small electric charge to deliver medications or other chemicals through the skin. Injection of a steroid into an infected site is to be avoided. The quantity and distribution of radiolabeled dexamethasone delivered to tissue by iontophoresis. Dr Guy and Dr Delgado-Charro provided project management. Study conclusion from 1999 ( PDF) by SMJ was: Iontophoresis using sterile water or corticosteroid resulted in minimal or no biochemical and histologic changes in the tendon compared with . In the cryotreated group, the levels of dexamethasone immediately after iontophoresis 3, 7, and 14 days after cryotherapy were 61.5 31.7 (n = 6), 88.4 55.1 (n = 6), and 112.2 32.5 (n = 6) mg/L, respectively, indicating that levels were lower compared with the group without cryotherapy. Treatment does not facilitate acclimation; further ascent should be delayed until the patient is asymptomatic while off the medication. : Endotoxin shock in pregnancy and abortion, in: Corticosteroids in the Treatment of Shock, Schumer, W.; Nyhus, L.M., Editors, Urbana, University of Illinois Press, 1970, pp. Serious neurologic events, some resulting in death, have been reported with epidural injection of corticosteroids. Neeter C, Thomee R, Silbernagel KG, et al. Suggested doses: Goodyear-Smith F, Arroll B. Congestive heart failure in susceptible patients, Aseptic necrosis of femoral and humeral heads, Peptic ulcer with possible subsequent perforation and hemorrhage, Perforation of the small and large bowel, particularly in patients with inflammatory bowel disease, Burning or tingling, especially in the perineal area (after IV injection), Other cutaneous reactions, such as allergic dermatitis, urticaria, angioneurotic edema, Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment, Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery, or illness, Manifestations of latent diabetes mellitus, Increased requirements for insulin or oral hypoglycemic agents in diabetics, Negative nitrogen balance due to protein catabolism, Myocardial rupture following recent myocardial infarction (see WARNINGS), Anaphylactoid or hypersensitivity reactions. The negative pole is pushing dexamethasone locally into the inflamed medial periarticular tissue for pain relief. Because rare instances of anaphylactoid reactions have occurred in patients receiving parenteral corticosteroid therapy, appropriate precautionary measures should be taken prior to administration, especially when the patient has a history of allergy to any drug. In these cases, iontophoresis is applied using a solution of dexamethasone, which helps to control the degenerative process that has been associated with tennis elbow while improving pain symptoms.It is different and better than corticosteroid injections because it is known that steroids directly applied in the articulation may impair the capacity of the tissue to repair itself, aggravating . The American Society of Hematology (2011) has recommended a longer course of corticosteroids (e.g. You can use the study as a second opinion to make health care decisions. Steroids may increase or decrease motility and number of spermatozoa in some patients. Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in: Acute noninfectious laryngeal edema (epinephrine is the drug of first choice). For a listing of the most commonly used drugs and their applications please refer to Table 1. Solutions used for intravenous administration or further dilution of this product should be preservative free when used in the neonate, especially the premature infant. This means that when a negatively charged medication, like dexamethasone, is applied to the negative drug pad, the medication will be forced away from the pad. high blood pressure. Dexamethasone iontophoresis (DIP) uses low-grade electric currents for transdermal dexamethasone delivery into deeper anatomic structures. This means that when a negatively charged medication, like dexamethasone, is applied to the negative drug pad, the medication will be forced away from the pad. Patients on immunosuppressant doses of corticosteroids should understand that a greater risk of infection exists; they should avoid exposure to chickenpox or measles and if exposed, they should consult their healthcare professional promptly. In less severe diseases doses lower than 0.5 mg may suffice, while in severe diseases doses higher than 9 mg may be required. "phoresis" refers to one organism or compound assisting the transport of another organism or compound". All authors provided concept/idea/research design and writing. Why? It is often used to decrease sweating, especially in the hands and feet, but it can also be used in physical therapy to decrease inflammation and scar tissue, and to reduce pain. Ganglia: 1 to 2 mg Dosage form: injection, solution The invention provides a dexamethasone sodium phosphate injection, which consists of 0.1 to 1 percent of dexamethasone sodium phosphate, 0 to 2 percent of medicinal propylene glycol, sodium dihydrogen phosphate: disodium hydrogen phosphate=0.01 to 0.1 percent of mixed phosphate buffer according to a ratio of 0-1:10, and the balance of water for injection, wherein the used dexamethasone sodium . Full disclaimer and more information about this site here. Why don't American traffic signs use pictograms as much as other countries? To tide the patient over a critical period of the disease in: Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, Loefflers syndrome not manageable by other means, Acquired (autoimmune) hemolytic anemia Medical Sciences Stack Exchange is not a substitute for medical advice, individualized diagnosis or treatment by a healthcare provider. Corticosteroids may exacerbate systemic fungal infections and therefore, should not be used in the presence of such infections unless they are needed to control drug reactions due to amphotericin B. Back To Index. The method of corticosteroid delivery may be as important as the actual drug effects on the biomechanical and histologic properties of tendons. Dexamethasone Iontophoresis Charge Software BatteryTimer v.1.1.0.6 BatteryTimer for the PocketPC allows you to simulate patterns of usage, and automatically log the remaining percentage battery charge in main and supplemental batteries.For example if you use your PocketPC for playing audio files for 2 hours a day. Of note, only 7 of the 16 patients had measurable dexamethasone in the tendon slip. Injectable Dex-Phos 0.4% (American Regent) was kindly provided by the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital, New York, NY. These mobile IontoPatches contain a small flat battery that provides a tiny electrical push of the target medication. See insert for other routes. . Corticosteroids may activate latent amebiasis. Each mL contains Dexamethasone Sodium Phosphate equivalent to dexamethasone phosphate 4 mg or dexamethasone 3.33 mg; benzyl alcohol 10 mg added as preservative; sodium citrate dihydrate 11 mg; sodium sulfite 1 mg as an antioxidant; Water for Injection q.s. A systematic review of nonsurgical management. Iontophoresis of dexamethasone: laboratory studies. Dexamethasone iontophoresis (DI) has been widely used in various concentrations for the treatment of . 8 mg oral/IV prior to chemotherapy followed by 4 to 8 mg oral/IV on days 2 and 3 Contributions of electromigration and electroosmosis to iontophoretic drug delivery. This drug is a part of most major treatment regimens in multiple myeloma; treatment regimens should be consulted. Nirschl RP, Rodin DM, Ochiai DH, Maartmann-Moe C. Iontophoretic administration of dexamethasone sodium phosphate for acute epicondylitis: a randomized, double-blinded, placebo-controlled study. Comments: Highly Emetogenic Chemotherapy Regimens: Specific events reported include, but are not limited to, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke. Schumer, W.; Nyhus, L.M. IV methylprednisolone, oral prednisone and prednisolone are the corticosteroids most studied and cited in clinical guidelines; while this drug has been used, efficacy studies and comparative data are lacking. by Ahmed Ibrahim Hammad (Author), Fatma Kamel (Editor), Eman Kaddah (Editor) & ISBN-13: 978-3659858826. Harris PR. A few studies have been conducted on iontophoresis; however most have been on the effects of different medications. Administration of live virus vaccines, including smallpox, is contraindicated in individuals receiving immunosuppressive doses of corticosteroids. Electrotransport system for transdermal delivery: a practical implementation of iontophoresis. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. A Verified Doctor answered. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The laboratory data indicate that more dexamethasone is delivered per unit charge (mAmin) by iontophoresis than by electroosmo- sis, thus the same amount of drug can be admin- istered in a shorter time from the negative elec- trode. 68 pages. Santi P, Guy RH. Cosentyx, Dupixent, Enbrel, Entyvio, Gilenya, Humira, Ilumya, Otezla, Promacta, Stelara. This may occur in patients even without evidence of adrenal insufficiency. Delgado-Charro MB, Guy RH. Cavanagh, D.; Singh, K.B. Frequent intra-articular injection may result in damage to joint tissues. The purpose of this study was to assess the safety and effectiveness of DIP for the treatment of TMJ involvement in JIA, and to delineate variables that are associated with improvement after DIP. 3 mg/kg of body weight per 24 hours by constant intravenous infusion after an initial intravenous injection of 20 mg, 2 to 6 mg/kg of body weight as a single intravenous injection, 1 mg/kg of body weight as a single intravenous injection, Dexamethasone Sodium Phosphate Injection, USP (equivalent to 4 mg per mL dexamethasone phosphate), MANUFACTURE(81565-202), ANALYSIS(81565-202). The medication is loaded in the active pad usually by syringe. There may be decreased resistance and inability to localize infection when corticosteroids are used. Dexamethasone Iontophoresis in Treatment of Epicondilitis . Counting from the 21st century forward, what place on Earth will be last to experience a total solar eclipse? Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever the solution and container permit. C. Iontophoresis. By clicking Accept all cookies, you agree Stack Exchange can store cookies on your device and disclose information in accordance with our Cookie Policy. Dexamethasone Sodium Phosphate is a water-soluble inorganic ester of dexamethasone. When oral therapy is not feasible and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, those products labeled for intravenous or intramuscular use are indicated as follows: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used), Preoperatively, and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful, Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected. 2011;2011 . These serious neurologic events have been reported with and without use of fluoroscopy. In the 0.4% perfused Dex-Phos (PD) experiment, the donor solution was continuously perfused with 0.4% weight-to-volume ratio Dex-Phos. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Package insert / prescribing information Corticosteroids appear in breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other unwanted effects. Li LC, Scudds RA, Heck CS, Harth M. The efficacy of dexamethasone iontophoresis for the treatment of rheumatoid arthritic knees: a pilot study. Formulated as a water soluble salt, the corticosteroid molecule has a negative charge and so the negative-electrode drug reservoir must be used. After 2 to 4 days, dose should be reduced and then gradually discontinued over a period of 5 to 7 days. Patients should understand that this drug is a corticosteroid and that it is important not to stop therapy abruptly. We comply with the HONcode standard for trustworthy health information. Soft tissue and intralesional injections should be limited to 1 or 2 sites. In patients undergoing brain surgery, may continue treatment for several days postoperatively. If a satisfactory clinical response does not occur after a reasonable period of time, discontinue Dexamethasone Sodium Phosphate injection and transfer the patient to other therapy. This drug has not been shown to reduce overall mortality, but has been shown to reduce hearing loss and neurological sequelae. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. If you're taking a high dose for long periods of time your doctor. During an exacerbation or as maintenance therapy in selected cases of: Severe erythema multiforme (Stevens-Johnson syndrome). A prospective, nonrandomized study of iontophoresis, wrist splinting, and anti-inflammatory medication in the treatment of early-mild carpal tunnel syndrome. Side effects The following side effects may be experienced in the areas treated for a short time after treatment: mild dysesthesia (sensory disturbance), such as tingling or burning sensation short-term skin irritation (redness) after treatment erythema (redness, short-term vesicles or blisters) Dr Sylvestre provided data collection and analysis. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The treatment is administered clinically for 1520 minutes per session. Very High Risk Situations (e.g. Yokogawa Measurement Technologies Ltd, Solar House, Mercury Park, Wycomber Lane, Woodburn Green, Bucks, HP10 0HH, United Kingdom. Terms in this set (68) What is Iontophoresis. Iontophoresis. The smallest effective dose should be used, preferably oral. Research indicates that increasing the current density under the membrane can only contribute so much to the total absorption of a specific drug molecule, with passive solvent flow being responsible for a significant portion of the total absorbed amount. People . This creates the necessary charge to drive the molecules into the target tissues. In a physical therapy setting, iontophoresis is typically one of several treatment interventions applied, so the addition of another 1520 minutes to a pre-existing 60 minute program is a time burden for some patients. Skin biological issues in electrically enhanced transdermal delivery. While Iontophoresis has been used to treat a variety of conditions, today the most common use of iontophoresis is to reduce local musculoskeletal inflammatory conditions with hydrocortisone, acetic acid, or dexamethasone sodium phosphate with or without lidocaine hydrochloride. ##Dionex (UK) Ltd, 4 Albany Ct, Camberley, GU16 7QL, United Kingdom. Dexamethasone Sodium Phosphate injection is particularly recommended for use in conjunction with one of the less soluble, longer-acting steroids for intra-articular and soft tissue injection. Dermadry Iontophoresis Device Results (2 Years Later) The long duration of action of this drug makes it unsuitable for alternate-day-therapy. Despite its widespread and long term use, the effectiveness of iontophoresis to increase the delivery of dexamethasone sodium phosphate (DSP) remains controversial. Fifth and sixth day: 0.75 mg orally once a day Connect and share knowledge within a single location that is structured and easy to search. Iontophoresis has been used to reduce sweating and enhances the delivery of drugs and macromolecules into and through the skin. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess, or other pyogenic infection, also in diverticulitis, fresh intestinal anastomoses, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, and myasthenia gravis. 2010-09-30 19:47:13. The clinician then sets the desired electrical dose (in mA-min) at a level that is comfortable for the patient. Research, however, suggests that this is not always the case. Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome. ISBN-10: 365985882X. Similar precautions to transdermal drug delivery of opiod medication, such as the Fentanyl patch, should be observedspecifically relating to the application of heat or cold to the patch. For more info on products mentioned in this article or for info on current product specials, please contact your personal MeyerDC Account Manager. Doses should be titrated based on patient response and severity of the condition; patients should be continuously monitored for signs that may require a dosage adjustment: Consult WARNINGS section for additional precautions. High-dose dexamethasone may be considered appropriate second-line treatment in those who have significant bleeding despite IVIg, anti-D, or a short course of corticosteroids. Patients should understand this drug is not curative; when injected into joints, they should not over use joints despite symptomatic improvement. Quantification of total dexamethasone phosphate delivery by iontophoresis. Clinicians manipulate the duration or the amplitude of the current, but it is not known which is more effective. Phenytoin, phenobarbital, ephedrine, and rifampin may enhance the metabolic clearance of corticosteroids resulting in decreased blood levels and lessened physiologic activity, thus requiring adjustment in corticosteroid dosage. Barnstead International, 2555 Kerper Blvd, Dubuque, IA 52001-1478. This research was supported by the National Institutes of Health (EB001420). This is not a labeled indication, but recommended in many anti-emetic protocols. The appearance of the deposits is usually one to two cm proximal to the rotator cuff insertion at the greater tuberosity of the humerus. Fresenius Kabi : High-output, low-resistance gram-negative septic shock in man, Angiology. Pikal MJ, Shah S. Transport mechanisms in iontophoresis, III: an experimental study of the contributions of electroosmotic flow and permeability change in transport of low and high molecular weight solutes. Dietzman, R.H.; Ersek, R.A.; Bloch, J.M. water, juices, applesauce, pudding), Consume entire contents immediately after mixing, Do not autoclave (steroids are sensitive to heat), Maybe used with or without dilution; IV solutions should be used within 24 hours. DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE AND THE RESPONSE OF THE PATIENT. A planet you can take off from, but never land back. To optimize Dex-Phos delivery, the drug must be delivered from the cathode, and the formulation should exclude, as far as possible, the presence of competing co-ions. Critical Reviews in Physical and Rehabilitation Medicine. Solute structure as a determinant of iontophoresic transport. BACKGROUND AND PURPOSE Iontophoresis is a process that uses bipolar electric fields to propel molecules across intact skin and into underlying tissue. Anderson CR, Boeh SD, Morris RL, et al. We comply with the HONcode standard for trustworthy health information. Banga AK, Panus PC. Hypersensitivity to any component of this product, including sulfites (see WARNINGS). During stress it may be necessary to increase dosage temporarily. Glass JM, Stephen RL, Jacobson SC. Dosing based on Wilderness and Environmental Medicine guidance. Handling unprepared students as a Teaching Assistant. False negative results in the dexamethasone suppression test (DST) in patients being treated with indomethacin have been reported. BSA 0.6 m2 or less: 2 mg IV/oral every 12 hours, BSA greater than 0.6 m2: 4 mg IV/oral every 12 hours. Characterization of the iontophoretic permselectivity properties of human and pig skin. Frequent intra-articular injection may result in damage to joint tissues. The slower rate of absorption by intramuscular administration should be recognized. Response is usually noted within 12 to 24 hours and dosage may be reduced after two to four days and gradually discontinued over a period of five to seven days. Medical Sciences Stack Exchange is a question and answer site for professionals in medical and allied health fields, students of those professions, related academics, and others with a sound understanding of medicine and healthcare-related sciences. Patients should be observed closely for signs that require dose adjustments; if therapy is to be stopped after more than a few days, it should be gradually withdrawn. Iontophoresis is used as a means of delivering drugs across the skin for the management of a variety of medical conditions, most often, we believe, for localized inflammation and pain. Prepare Site Prepare the site by trimming hair, cleaning the skin, and drying the area thoroughly. Why don't math grad schools in the U.S. use entrance exams? Average and large doses of cortisone or hydrocortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. Maximum dose: 16 mg Corticosteroids should not be injected into unstable joints. Evaluation of iontophoretically applied dexamethasone for painful pathologic temporomandibular joints. It is thought that dexamethasone (DEX) can be driven up to 20 mm into the tissues with tissue concentration decreasing exponentially with tissue depth. Long-term treatment with this high potency, long half-life steroid is associated with severe hypothalamic-pituitary adrenal (HPA) suppression and therefore use is generally limited to short-term, severe, acute situations. 86-96. https://www.practicalpainmanagement.com/treatments/interventional/iontophoresis-pain-management, A novel approach to the treatment of neck pain and postural dysfunction. Use: For the treatment of acute, self-limited allergic disorder or exacerbation of chronic allergic disorder. Schumacher HR, Chen LX. Dexamethasone Sodium Phosphate injection contains sodium bisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. Drug-induced secondary adrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosage. By clicking Post Your Answer, you agree to our terms of service, privacy policy and cookie policy. If inactivated viral or bacterial vaccines are administered to individuals receiving immunosuppressive doses of corticosteroids, the expected serum antibody response may not be obtained. Dexamethasone phosphate (Dex-Phos) iontophoretic flux as a function of concentration in deionized water. The initial dosage should be maintained or adjusted until the patients response is satisfactory.
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